Lancashire and South Cumbria NHS Foundation Trust (LSCft) provides inpatient and community mental health services across Lancashire and South Cumbria, employing around 7,000 staff in more than 400 locations. The Trust also provides a range of physical health services to parts of the area including community nursing, health visitors together with a range of therapy services including physiotherapy, podiatry, speech and language.
In addition, wellbeing services are also provided which includes healthy lifestyle and living and smoking cessation. Trust services are provided to a population in excess of 1.5 million people from different cultures, religions and educational backgrounds, housed in some of the most densely populated, socially and economically challenged areas of Europe.
The Trust’s vision is to support our local communities by excelling in everything we do together, to be kind, to be respectful, always to be learning and to provide services as a team.
Our Chair’s Foreword
LSCft fully supports the published research by organisations such as The Lancet and The World Health Organisation (WHO) that climate change is the “biggest global health threat of the 21st Century” and that the impact on people’s lives and human health is already evident through increases in extreme periods of weather, coupled to more frequent, intense weather events. The NHS England and Improvement (NHSE-I) 2020 report “Delivering a Net Zero National Health Service”, highlighted that left unabated climate change will disrupt care, with poor environmental health contributing to major diseases, including cardiac problems, asthma and cancer. With the impact of climate change increasing directly with the amount of carbon emissions in our atmosphere, the Government introduced the Climate Change Act 2008 (CCA). Revised in 2020 the CCA places a legal requirement on the Government to reduce carbon emissions, with a legally binding target of net-zero carbon emissions by 2050. The NHS have committed to become the world’s first ‘net zero’ National Health Service and have set challenging targets to achieve this.
For the scope 1 emissions the NHS control directly (the NHS Carbon Footprint), the target is to achieve net zero by 2040, with an ambition to reach an 80% reduction by 2028 to 2032.
For the scope 2, 3 and + emissions the NHS can influence (our NHS Carbon Footprint Plus), the target is to achieve net zero by 2045, with an ambition to reach an 80% reduction by 2036 to 2039.
LSCft is one of the largest employers and a main purchaser of goods and services in the Lancashire and South Cumbria area, and as such, activities have a significant carbon footprint. LSCft’s Green Plan (GP) outlines the strategy to reduce carbon emissions, whilst improving sustainable outcomes and adapting to the impacts of climate change.
LSCft will increase the knowledge and understanding of net zero and sustainable development of all employees with the provision of specific ‘Greening the NHS’ e-learning training. The implementation of the GP will increase opportunities to help make healthcare services sustainable now and for future generations. In addition to focusing on improvements in training and development, the Trust will continue to improve the procurement of goods and services in an optimally sustainable way by reducing building energy demands, improving access to sustainable transport, minimising waste generation and increasing recycling rates. LSCft will work in partnership with all services to embed sustainability throughout the organisation.
LSCft can play a key role in supporting and developing a sustainable healthcare service, which will improve the quality of health and wellbeing for future generations. By following the strategy set out in the GP, the aim is to set the benchmark and expectations for best practice in sustainability meeting the Trust’s corporate social responsibility and ensuring sustainable healthcare for the population it serves.
All of us have a responsibility and a role to play in ensuring this GP is successfully implemented and embedded, and this can only be achieved by working in collaboration and together.
David Eva
Chair of the Board
Introduction
The Green Plan (GP) is LSCft’s strategic organisational plan, which sets out the Trust’s ambitions for Net Zero Carbon (NZC) 2040 targets, sustainable development activities across Lancashire and South Cumbria. The GP is a mechanism for the Trust to take a co-ordinated, strategic and action-orientated approach to NZC, sustainability and social value.
What do we mean when we use the term ‘Net Zero Carbon’? Put simply, NZC refers to the balance between the amount of Green-House-Gas (GHG) emitted and the amount removed from the atmosphere. NZC is reached when the amount emitted is no more than the amount taken away.
What do we mean when we use the term Sustainable Development (SD)? Put simply “development that meets the needs of the present without compromising the abilities of future generations to meet their own needs”. The concept of sustainable development requires that full and equal considerations are given to the social, economic and environmental issues surrounding decision-making processes. The social, economic and environmental outcomes of decisions made are interconnected, and neglecting or exploiting one area will lead to unsustainable service delivery and increase the negative social, economic and environmental impacts to the Trust.
Delivering NZC / SD covers all staff from all directorates throughout the Trust. The whole Trust; this is inclusive of all employees, whether directly employed, employed by bank or agency, contractors and suppliers. The GP will monitor and manage the Trust’s environmental aspects, carbon footprint and carbon emissions from all buildings, energy consumption, waste generation, water consumption / disposal, procurement, transportation of staff, patients, goods and services.
LSCft is committed to delivering world-class sustainable healthcare service now and in the future, this GP sets out LSCft’s targets and planned actions to reduce carbon emissions in line with the legislative targets set by the Climate Change Act 2008. LSCft will make annual carbon data submissions to the Sustainable Development Unit (‘SDU’) and publish the Trust’s annual carbon footprint.
Generally, actions taken to reduce carbon emissions have a lead period and optimal reductions may not be recorded until the following year. Although the Trust has been actively reducing carbon emissions, carbon reduction actions have been disrupted due to the ongoing Covid-19 pandemic.
In October 2019 the Trust commenced the provision of services in South Cumbria. This expansion has increased the Trust’s carbon footprint by 800 tCO2e. Table 1 highlights progress made up to the financial year 2019 / 20 with the future NHS CNZ targets.
Carbon Emission Reduction Progress / Targets CO2 Emissions tCO2e
Confirmed figures from SDU
- 2013/14 (baseline): 71,140
- 2014/15: 73,415
- 2015/16: 65,542
- 2016/17: 61,572
- 2017/18: 59,245
- 2018/19: 51,852
- 2019/20: 43,775
Carbon tonnes target
- 2013/14 (baseline): 71,140
- 2014/15: 67,583
- 2015/16: 64,269
- 2016/17: 61,180
- 2017/18: 57,624
- 2018/19: 54,006
- 2019/20: 51,220
- 2028/2032: 14,228
- 2040: net zero
Percentage change from baseline
- 2013/14 (baseline): 0%
- 2014/15: + 3%
- 2015/16: - 9.3%
- 2016/17: - 13.5%
- 2017/18: - 17%
- 2018/19: - 27%
- 2019/20: - 38%
- 2028/2032: - 80%
Percentage target from baseline
- 2014/15: - 5%
- 2015/16: - 10%
- 2016/17: - 14%
- 2017/18: - 19%
- 2018/19: - 24%
- 2019/20: - 28%
- 2028/2032: - 80%
- 2040: - 100%
The Trust has made excellent progress to surpass the 2020 carbon target. However, there is a lot of work to do to achieve the 2040 NZC target. The trajectory to NZC emissions for a complex, highly specialised system as large as the NHS is particularly challenging and inclusive of all areas of the NHS or Trust.
The Trust use the Sustainable Resource Planning toolkit to report their carbon footprint annually. LSCft have completed the Sustainable Development Assessment Tool (‘SDAT’). The SDAT is an online self-assessment tool to assist and understand sustainable development work, measure progress and help make plans for the future. It uses four cross-cutting themes:
- Governance and Policy
- Core Responsibilities
- Procurement and Supply Chain
- Working with Staff, Patients and Communities.
The latest (2018) LSCft SDAT assessment achieved 56%, highlighting that progress has been made towards the United Nations’ Sustainable Development Goals. SDAT is currently being updated by the national greening the NHS team.
Drivers for change
In October 2020 NHS England and NHS Improvement (NHSE&I) unanimously approved a strategy to limit and adapt to the health emergency caused as a consequence of climate change, due to the ongoing Covid-19 crisis this was reaffirmed in September 2021. The strategy “Delivering a Net Zero National Health Service” provides a framework of implementations and interventions to eliminate carbon emissions from all areas of the NHS and achieve NZC by 2040. The strategy requires all Trusts to produce a GP.
The actions of the NHS extend beyond treating people and by placing a strong emphasis on overall sustainability the NHS is developing alternative and innovative ways of working that deliver social, economic and environmental benefits for society. The NHS with over 80,000 suppliers of goods and services will play a pivotal role in enabling supplier progression to promote sustainable development and NZC. The NHS will play a major role in limiting their indirect emissions (Scope 2, 3 and +) and importantly support suppliers to reduce emissions and incorporate NZC into NHS supply process. Figure 2 highlights the road map to build NZC into the procurement process.
Further drivers for change for LSCft can be categorised into the following key groups, which provide the legal and policy context in improving sustainability across the Trust:
- Legislative requirements
- National NHS guidance
- Mandatory requirements
- International guidance
- UK guidance
- Health specific requirements
The details and requirements set out within these key drivers will underpin the delivery of long-term
financial, environmental and social sustainability within LSCft, the healthcare system and the wider NHS.
Legislative requirements
Civil Contingencies Act 2004: The Civil Contingencies Act 2004 establishes a clear set of roles and responsibilities for those involved in emergency preparation and response at a local level. Critically, organisations such as the NHS must demonstrate that they have undertaken risk assessments and that carbon reduction delivery plans, mitigation and adaptation to climate change are in place. LSCft must consider overlaps between adapting to climate change and preparing for emergency scenarios. For example, the overheating of Trust buildings and potential loss of staff hours due to overheating is a business continuity issue as well as a climate change issue and, as such, must be addressed under the Trust’s Emergency Preparedness, Resilience and Response (EPRR) plan.
Climate Change Act 2008: The Climate Change Act 2008 sets legally binding targets for the UK Government to reduce carbon dioxide emissions, with an overall target of Net Zero Carbon by 2050. All public sector organisations are required to develop carbon reduction and sustainable plans in order to achieve this target. Following the strategy outlined in this GP will ensure LSCft are working towards this target, and any risks in achieving this target identified. Carbon emissions are reported annually and measured against a pre-determined baseline.
Environmental Protection Act 1990: The Environmental Protection Act 1990 makes provision for the improved control of pollution to the air, water and land by regulating the management of waste and the control of emissions. Key provisions of the Act impose a duty of care on any business or person who produces, carries, keeps, treats, disposes of or imports controlled waste to do so safely. Contractors providing waste services on behalf of LSCft must report on waste disposal and provide a waste management plan. LSCft currently measure waste across the Trust against an implemented waste matrix.
Public Services (Social Value) Act 2012: The Public Services (Social Value) Act 2012 came into force in January 2013 and requires all public bodies in England and Wales to consider how their services may improve the economic, social and environmental wellbeing of the local community. The legislation sits alongside other procurement laws and outlines how procurement decisions must focus on value for money whilst also considering the wider implications in terms of the local community.
United Kingdom Emissions Trading Scheme (‘UK ETS’): The UK ETS replaced the European Union Emissions Trading Scheme (‘EU ETS’) from January 2021. The 4 governments of the UK have established the scheme to increase the climate ambition of the UK’s carbon pricing policy, whilst also protecting the competitiveness of UK businesses.
Mandatory requirements
Standard Form Contract Sustainable Development 2020 – 21: The NHS Standard Contract is mandated by NHS England for use by commissioners for all contracts for healthcare services other than primary care.
HM Treasury Sustainable Reporting Framework: The guidance sets the minimum requirements that must be met, provides best practice examples and includes underlying principles that should be adopted in preparing information for reporting on sustainability in annual reports and accounts for LSCft.
International requirements
EU Waste Directive: Directive to reduce waste and increase recycling rates of members’ countries with significant financial penalties for non-compliance. LSCft has a waste matrix in place which identifies waste and recycling rates across the Trust, with the aim of reducing waste by promoting reuse, recycling and then energy being recovered from any waste items remaining.
Intergovernmental Panel on Climate Change (‘IPCC’) AR5 2013: The Intergovernmental Panel on Climate Change (IPCC) is an intergovernmental body of the United Nations, dedicated to providing the world with an objective, scientific view of climate change, its natural, political and economic impacts and risks, and possible response options. LSCft supports the United Nations’ objectives through the 17 Sustainable Development Goals.
World Health Organisation (‘WHO’) Toward Environmentally Sustainable Health Systems in Europe: Ensuring environmental sustainability and reducing the environmental footprint of the health systems throughout the region remain important objectives and responsibilities of Member States. Towards these goals, LSCft will assess and improve their environmental performance and efficiency in the use of resources. This will contribute to global mitigation goals and adaptation to climate risks, whilst also enhancing their overall sustainability and resilience.
UK guidance
National Policy and Planning Framework 2012: The National Policy and Planning Framework sets out the Government’s planning policies for England and how these are expected to be applied. This is inclusive of building thermal retention requirements and adaption to climate change. LSCft must incorporate these policies into any future developments.
DEFRA Economics of Climate Change: Develops an economic framework to assess the case for adaptation in the UK. The analysis investigates current and likely adaptation actions and identifies the key barriers and enablers to actions being implemented widely, effectively, timely and proportionate to the challenges facing the UK. The project will inform the National Adaptation Programme.
The Stern Review 2006: Assessment of a wide range of evidence on the impacts of climate change and on the economic costs, using a number of different techniques to assess costs and risks. From all of these perspectives, the evidence gathered by the review leads to a simple conclusion; the benefits of strong and early action far outweigh the economic costs of not acting.
UK Air Quality Strategy: This strategy sets out our plans for dealing with all sources of air pollution, making our air healthier to breathe, protecting nature and boosting the economy. The expectation is that there will be increasing levels of legislation and financial penalties for levels of poor air quality as the health impacts become established as scientific fact.
The Building Research Establishment’s Environmental Assessment Method (‘BREEAM’): BREEAM is a widely used environmental assessment method for buildings. The scheme has sector specific assessment methods of which one is healthcare. BREEAM sets a standard for best practice in sustainable design and has become the de facto measure used to describe a building’s environmental performance. LSCft will aim to achieve BREEAM targets for new builds and major refurbishments.
Health specific requirements
NHS Long-Term Plan: Sustainable healthcare provides a greater emphasis on prevention, person-centred care, lean pathways, carbon reduction and efficiency targets.
Sustainable Development Strategy for the Health and Social Care System: A vision for a sustainable healthcare system by reducing carbon emissions, protecting natural resources, preparing communities for extreme weather events and promoting healthy lifestyles and environments.
Integrated Care System (ICS): Integrated healthcare between the NHS, local councils and other partners to improve health care. The role of the ICS is to provide services in a more coordinated way, to agree system-wide priorities, and to plan collectively how to improve residents’ day-to-day health.
Delivering a Net Zero National Health Service: The report provides a detailed account of the NHS modelling and analytics underpinning the latest NHS carbon footprint, trajectories to net zero and the interventions required to achieve that ambition. It lays out the direction, scale and pace of change required. It describes an iterative and adaptive approach, which will periodically review progress and aims to increase the level of ambition over time.
Lancashire and South Cumbria NHS Foundation Trust’s Organisational Vision and Goals
LSCft recognises the huge impact the health emergency caused by the impacts of climate change can have on the ability to deliver world-class healthcare, both now and in the future and the need to deliver sustainable NZC services. LSCft is therefore dedicated to ensuring that sustainable models of care are embedded throughout all Trust activities and operations.
LSCft’s vision is to lead by example on NZC and SD and ensure that the correct considerations between social, economic and environmental performance are achieved with negative outcomes minimised. Once LSCft is recognised as being a leader between other Lancashire NHS Trusts and public sector partners, it would be part of the GP’s communication strategy to then share best practice and work with the other Trusts and partners.
LSCft’s vision for sustainable healthcare must be embedded within the Trust’s culture, workplace practices and supply chain by recognising that LSCft can achieve more by working in partnership with each other.
Underpinning LSCft’s vision and this strategy are three overarching goals for 2022 to 2025:
Goal 1
To ensure the Trust is in the optimal position to prioritise interventions which simultaneously improve patient care, community wellbeing while tackling climate change, carbon reduction and improve broader
sustainability issues the Trust will establish a board level “Greening the NHS Implementation and Governance Group” (GIG). The GIG will ensure the health emergency created via the impacts of climate change are at the forefront of the decisions making process and the translation of the national NZC 2040 targets and strategy are incorporated into every departmental and clinical service provision, strategies and policies.
Goal 2
To introduce mandatory strategic sustainable training for Trust Board, Governors and all senior management teams. The Trust, by introducing strategic sustainable and NZC training will be ensuring that the workforce are being provided with the knowledge, skills and understanding to develop and deliver carbon reduction actions, improve sustainable outcomes and improve sustainable health services.
Goal 3
Incorporate NZC into all Trust policies and strategies throughout every area of the Trust.
LSCft Action Plan 2022 to 2025
The below outlines the actions that will be taken over the duration of this GP strategy in supporting the achievement of LSCft’s vision and goals:
- LSCft will report annually on progress to reduce carbon emissions and actions will be taken to mitigate the impacts of climate change
- LSCft will review the building portfolio and take actions to improve energy efficiency and seek funds to invest in new energy generation and energy saving equipment, such as SMART metres
- LSCft will provide strategic sustainable development and NZC training for Executive Board, senior management and all colleagues where appropriate
- LSCft will incorporate sustainable development and NZC into the LSCft employee induction process to promote the right culture and expectations across the Trust
- LSCft will develop a ‘Sustainable Green Champions Group’ (SGCG) formed of representatives from a range of different services across the Trust, such as Estates and Facilities, Procurement, Finance, HR, IT, Communications and Learning and Development
- LSCft will develop a Communications Strategy so that all staff are provided the correct information and given the opportunity to suggest actions to reduce carbon, improve sustainability and get involved SGCG
- LSCft will reduce waste generation and work with suppliers to reduce packaging with particular focus to eliminate single-use plastics
- LSCft will increase the segregation of waste and recycling rates across the Trust by providing specific waste and clinical waste management training and providing additional recycling facilities
- LSCft new staff will have sustainable and NZC included in their job descriptions
- LSCft staff will participate in actions to minimise energy consumption and utilise energy efficiency equipment
- LSCft will utilise energy efficiency equipment in all maintenance works, refurbishments and new-builds, such as replacing old lights with LED
- LSCft staff will participate in actions to minimise water consumption and utilise water efficiency equipment
- LSCft will promote sustainable transport and provide resources to increase levels of usage of sustainable transport
- LSCft will develop and implement an LSCft Car Sharing Scheme to reduce carbon emissions
- LSCft will promote health and wellbeing initiatives to encourage active travel where possible
- LSCft will promote sustainable procurement and produce a sustainable procurement strategy that will embed all tender specifications
- LSCft will incorporate sustainability requirements into all project and contractor tender specifications
- LSCft will continue to promote and grow the Trust’s Grow Your Own scheme which supports rehabilitation and the community.
LSCft’s Contribution to the United Nation’s Sustainable Development Goals
Click on each goal below to view our contribution to each.
LSCft contribution: LSCft are living wage employers, reducing the risk of staff experiencing food and fuel poverty.
LSCft contribution: LSCft support staff on how to reduce food wastage to reduce their environmental impact, and to help support staff avoid food poverty. LSCft have targets to increase the amount of healthy and sustainable food choices in our organisation which meet CQUIN standards. These focus on catering services provided, products available for staff, service users and public to purchase in vending machines, and also retail outlets located within the LSCft estate.
LSCft contribution: LSCFT’s workforce strategy has been independently verified for positive impacts on health, wellbeing and sustainable development (e.g. investors in people).
LSCft contribution: LSCft promote life-long learning and all staff have an annual Performance Development Review (PDR) which is monitored and tracked by Human Resources.
LSCft contribution: LSCft have an Equality and Diversity Policy that measures the Trust’s access to equal opportunities and is aligned to requirements under the Equality Act (2010) and the Public Sector Equality Duty. As part of the Policy, there are no gender specific roles across LSCft.
LSCft contribution: LSCft have developed plans that link to this Green Plan to reduce energy and water demand to improve water and energy efficiency, in line with the NHS Sustainable Development Strategy and the Climate Change Act (2008).
LSCft contribution: From April 2020 LSCft purchase 100% renewable electricity. LSCft monitor energy and water use closely across all sites (owned and leased), using SMART meters and dedicated utilities management software. LSCft also deliver an ongoing programme of energy efficiency measures, such as installation of LED lighting, use of a biomass boiler and Building Energy Management System upgrades.
LSCft contribution: LSCft work with ICS, local strategic partnership and other key partners to plan improved access to employment opportunities in the organisation. LSCft also provide work experience placements and apprenticeships.
LSCft contribution: LSCft promote the use of telecommunications to reduce the need to travel. All patient records are being digitised to reduce paper storage, waste and increase availability. Energy efficiency technologies are utilised to preserve resources and reduce financial and carbon costs.
LSCft contribution: LSCft are members of the International Health Partnership scheme, where trained clinical staff volunteer in low or middle income countries to provide mutually beneficial outcomes through sharing expertise and learning.
LSCft contribution: LSCft empower service users to become experts in their own recovery. LSCft are designing and developing a high quality, robust and effective Recovery College (RC) model. The Recovery College will provide a range of courses and workshops to service users, carers and members of staff to develop their skills, understand mental health, identify goals and support their access to opportunity. The Grow Your Own scheme also promotes service user rehabilitation and growth by supporting users through related qualifications as part of their journey.
LSCft contribution: LSCft work with suppliers to improve sustainable outcomes of procured goods and services. LSCft are proactive in improving efficiencies in energy management and have several renewable energy projects ongoing.
LSCft contribution: The effects of climate change are embedded in LSCft’s Risk Register, in relation to clinical needs, types of clinical intervention, the quality of the estate and supporting infrastructure.
LSCft contribution: LSCft’s main catering supplier has a robust environmental policy to eliminate single-use plastics and only procure fish from sustainably sourced suppliers.
LSCft contribution: LSCft design new buildings and access routes to buildings with embedded green space and use green space constructively. LSCft also have a ‘Grow Your Own’ facility for service users and community groups.
LSCft contribution: LSCft have a clear and publically available Modern Slavery Statement (‘MSS’.) The MSS is regularly reviewed and updated.
LSCft contribution: LSCft is an active member of the Sustainable Transformation Plan group and contributes to the national Sustainable Development Unit and regional partnerships.
Areas of Focus
Corporate Approach: To ensure that the issues of carbon reduction and sustainable development are fully understood and integrated into the decision making process.
Click on the actions below to view our measures and reports.
Measure: date of the appointment
Report: Board member to be provided with quarterly updates on progress.
Measure: date group is established
Report: group members will meet quarterly to ensure ongoing progress
Measure 1: design a training programme for colleagues
Measure 2: numbers of colleagues trained
Report 1: include a comprehensive sustainable annual report
Report 2: include a comprehensive sustainable annual report
Measure 1: survey new colleagues on the job description and the inclusion of sustainable development
Report 1: date sustainable development has been included in job description
Measure 2: survey new colleagues on the job description and the inclusion of sustainable development
Report 2: report as part of the HR recruitment process
Measure 3: number of colleagues inducted
Report 3: included in the monthly Estates Management Assurance Meeting (‘EMAM’) report and the sustainable annual report
Measure 4: number of colleagues completing e-learning
Report 4: included in the monthly EMAM report and the sustainable annual report
Measure: record number of opportunities presented
Report: included in the monthly EMAM report
Measure: nominated procurement lead to design and implement an SPS
Report: number of items replaced with sustainable alternative
Travel and logistics
LSCft provide services in a large geographical area coupled to patient travel, staff commute and site to site travel means that Travel accounts for a significant proportion of carbon emissions. LSCft will aim to introduce a Sustainable Travel Plan that will promote active travel and reduce single occupancy journeys.
Click on the actions below to view our measures and reports.
Measure 1: the publication of the Sustainable Active Travel Plan
Report 1: included in the monthly EMAM report and the sustainable annual report
Measure 2: number of colleagues participating in active travel
Report 2: health and wellbeing annual report
Measure 1: implement hybrid mail solution linked to clinical systems
Report 1: included in the monthly EMAM report and the sustainable annual report
Measure: included in all new builds and major refurbishments
Report: monitor the number of equipment installed and report via the project contract reporting schedule
Measure: monitor use of EVCP, electrical consumption and carbon offset
Report: included in the monthly EMAM report
Measure: number of electric vehicles in the fleet
Report: included in the monthly EMAM report
Measure: amount of TEAMS meeting usage
Report: IT to provide report
Measure: record the number of homeworking days
Report: HR to provide report
Capital projects
The Trust has replaced and rationalised much of its estate with purpose designed accommodation and this will continue with plans to build new and refurbish accommodation across the Trust to provide modern recovery focused mental health and community services delivered in the community and people’s homes.
Click on the actions below to view our measures and reports.
Measure: the production of the Decarbonisation Plan
Report: implementation of decarbonisation actions. Reported to the GIG and ICS
Measure: review the energy / water efficiency of essential equipment being installed and recommend best sustainable option
Report: monitor the number of equipment installed and report via the facilities management contract reporting schedule
Measure: number of installations and the amounts of energy generated / carbon offset
Report: included in the monthly EMAM report and SDU submission
Measure: engage a fully inclusive bureau service to manage BEMS
Report: included in the monthly EMAM report
Measure: Inclusion of sustainable questions in the tender evaluation process.
Report: Included in the monthly EMAM report.
Measure: Number of named staff trained to operate building controls.
Report: Included in the facilities management contract reporting schedule.
Sustainable Care Models
LSCft has the opportunity to play a key leadership role in the transition to a sustainable healthcare provider. LSCft can improve health and wellbeing for the current and future generations by taking sustainable actions and incorporating these actions into healthcare pathways.
Measure: The number of equipment purchased / best sustainable option.
Report: Procurement to provide data / report.
Measure: Number of digital communication interactions.
Report: Included in the monthly EMAM report.
Measure: Number of installations with improved sustainable controls.
Report: Included in the monthly EMAM report.
Measure: List the number of partners working to improve sustainable outcomes.
Report: The number of partnership projects completed.
Measure: Design of the sustainable appraisal tool appropriate for each care pathway.
Report: Number of sustainable appraisals carried out and implementation of sustainable care pathway interventions.
Sustainable Use of Resources
The Trust generates a large amount of waste materials that have to be disposed of in line with current legislation. Waste disposal has significant social, economic and environmental impacts. The Trust will apply the waste hierarchy and reduce waste whenever possible, reuse / redistribute equipment, recycle by providing recycling facilities at all LSCft main sites and recover energy from waste if appropriate.
Measure: The amounts of waste being collection in yellow, orange and tiger bags.
Report: Included in the monthly EMAM report.
Measure: The amount of materials being reduced or returned to suppliers.
Report: Included in the monthly EMAM report.
Measure: Number of sites with recycling facilities and type of recycling facilities.
Report: Included in the monthly EMAM report.
Measure: Number of sites with food waste reduction projects and collections.
Report: Included in the monthly EMAM report.
Measure: Number of sites with healthy choice vending machines.
Report: Reported via the Government’s CQUIN incentives.
Measure: Record the amount of projects and items being recycled, reused, redistributed.
Report: Included in the monthly EMAM report and SDU submission.
Asset Management and Utilities
LSCft will ensure that the estate portfolio is rationalised to deliver optimal service from minimal buildings and assets. LSCft will fully utilise SMART meters to monitor and target energy consumption and increase the amount of renewable energy generation throughout the Trust.
Measure: Review equipment energy and water efficiency levels and ensure best sustainable options are installed.
Report: Monitor the number of equipment installed and report via the facilities management contract reporting schedule.
Measure: Number of installations and the amounts of energy generated and carbon offset.
Report: Included in the monthly EMAM report and SDU submission.
Measure: Engage a fully inclusive bureau service to manage BEMS.
Report: Included in the monthly EMAM report.
Measure: Number of SMART or AMR enabled meters submitting data.
Report: ERIC returns and the SDU annual carbon submission.
Measure: Number of projects completed and the reduction in consumption and carbon offset.
Report: Included in the monthly EMAM report and the sustainable annual report.
Measure: Energy and water consumption ratings to be included in the procurement process.
Report: Procurement and IT to provide details on the purchasing of energy water intensive equipment and options for reduction.
Measure: The amount of sites with economically viable decarbonisation plans.
Report: Included in the monthly EMAM report and the sustainable annual report.
Adaptation Climate Change
The negative impacts of climate change are extensive and include, but are not limited to, rising global temperatures, loss of habitat, deforestation, desertification, increased precipitation, ice / glacial melt, sea level rise, flooding and extreme weather events.
Importantly actions taken now to eliminate carbon emissions and limit the impacts of climate change will have direct improvements to people’s health and patient care. However, delaying actions to reduce carbon emissions or if carbon emissions are left unabated, will lead to loss of life, impact public health both physically and mentally,
disrupt the provision of health services and affect every stage of society - reversing the hard earned health gains we have experience for many years. Adapting to the impacts of climate change is critical to the provision of sustainable health care.
The UK Climate Change Risk Assessment (2021) outlined eight interrelated climate change risks that require immediate attention:
- Risks to human health, wellbeing and productivity from increased exposure to heat in homes and other buildings
- Risks to people and the economy from climate- related failure of the power system
- Risks to supply of food, goods and vital services due to climate-related collapse of supply chains and distribution networks
- Risks to crops, livestock and commercial trees from multiple hazards
- Risks to the viability and diversity of terrestrial and freshwater habitats and species from multiple hazards
- Risks to soil health from increased flooding and drought
- Risks to natural carbon stores and sequestration from multiple hazards leading to increased emissions
- Multiple risks to the UK from climate change impacts overseas
Measure: The publication of the plan.
Report: Board report.
Measure: Publish corporate lead.
Report: Regular reports to corporate lead.
Measure: Review of BCP to incorporate climate change impacts.
Report: Inclusion of climate change measures into the BCP.
Measure: Review of BCP to incorporate climate change impacts.
Report: Inclusion of climate change measures into the BCP.
Measure: Environmental and flood impact assessment to be carried out on new builds and major refurbishments.
Report: New builds and refurbishment report to project board.
Green Space and Biodiversity
The provision of green space and biodiversity has a positive impact on wellbeing and mental health. LSCft has a large portfolio of buildings and grounds that will be utilised to promote green space and biodiversity.
Measure: The production of the plan and action and projects completed.
Report: Included in the monthly EMAM report.
Measure: Actions taken to promote green space and biodiversity.
Report: Included in the monthly EMAM report.
Measure: Record rehabilitation, meetings and corporate days.
Report: Included in the monthly EMAM report.
Our People
LSCft will engage with and provide the correct levels of sustainable knowledge to all staff via specific training and development, communications and through the staff induction and e-learning processes.
Measure: Design a training programme for colleagues.
Report: Date training has been completed.
Measure: Survey new colleagues on the job description and the inclusion of sustainable development.
Report: Report as part of the HR recruitment process.
Measure: Number of events attended.
Report: Included in the monthly EMAM report.
Carbon and GHGs
LSCft will monitor, measure and report on their carbon footprint annually. Ongoing analysis of carbon emissions will identify carbon “Hot-Spots” and LSCft will devote resources to reduce carbon emission throughout the timeframe of this strategy.
Measure: Annual carbon data submitted to SDU.
Report: ERIC returns and the SDU annual carbon submission.
Measure: Record carbon reduction actions.
Report: ERIC returns and the SDU annual carbon submission.
Measure: Record actions from partners, suppliers and stakeholders.
Report: Included in the monthly EMAM report.
Tracking Progress
LSCft will follow nation greening the NHS guidance to ensure that the progress of this strategy is measured against both qualitative and quantitative data. Quantitative data will be collected and analysed on a monthly basis for both energy, water consumption and commercial fleet mileage across the Trust. A more detailed analysis is also carried out by the Trust’s nominated energy management bureau service to identify any anomalies as they arise. In addition, waste data is collected monthly for each waste stream at each site. The organisational carbon footprint is also measured and reported annually using national guidance.
Staff travel will also be monitored and reported via the Health Outcomes of Travel Tool (‘HOTT’), which could include an annual staff survey to ascertain how staff travel to work.
Social value is also tracked within tenders, such as SME spend and weighting, by working closely with the Procurement team at FT.
Governance
The NHS are the first health care organisation in the world to implement a comprehensive strategy to achieve NZC and with over a decade of experience in reducing carbon emissions, the NHS are in a good position to accelerate carbon reduction / sustainable actions. However, the journey to NZC is complex, the targets are challenging and importantly will require all areas of the NHS to work in partnership and aligned core business and health strategies to the carbon reduction agenda and climate changes adaptation process.
This will undoubtable require changes in the way we provide health care, the way we procure our medicines and medical equipment, the way we travel to meetings and appointments, the way we build and manage buildings, the way we recruit and train our staff, the way we fuel and drive our vehicles, the way we procure our goods and services. As outlined in LSCft’s vision for delivering sustainable healthcare, the GP can only be effectively implemented with the joint collaboration and participation of the whole organisation. Therefore, clear direction regarding the implementation of the Trust’s strategy is required.
To ensure the Trust are in the optimal position to prioritise interventions which simultaneously improve patient care and community wellbeing while tackling climate change, carbon reduction and improve broader sustainability issues the Trust will establish a “Greening the NHS Implementation and Governance Group” (GIG). The purpose of the GIG is to bring together the knowledge, experience and understanding, from key colleagues throughout LSCft to implement the actions in the Trust’s GP and support the Trust’s GP and environmental policies. The GIG will ensure the health emergency created via the impacts of climate change are at the forefront of the decisions making process and the translation of the national NZC 2040 targets and strategy are incorporated into all departmental and clinical service provision, strategies and policies.
Membership of the GIG must be from all areas of the Trust with senior representation from clinical areas.
- Board of Executives
- Infrastructure Sub-Committee
- Estates Management and Assurance Meetings
- Sustainability Green Champions Group
- Staff led user groups
- Governors
- Service users
Reporting
LSCft will ensure robust processes are in place to report the progress and results of the GP throughout predetermined frequencies to the relevant bodies.
Annual
Complete SDU’s Sustainability Reporting Portal which calculates the Trust’s carbon emissions. LSCft Sustainability Report which provides an annual progress report against the Trust’s GP.
Estates Return Information Collection (‘ERIC’) which is a mandatory data collection for all NHS Trusts required by the Department of Health.
Quarterly
Internal progress reports are submitted to LSCft, Estates and Facilities Senior Leadership Team and the GIG.
Monthly
Internal progress reports are collected from suppliers outlining energy, waste and water consumption. Internal progress reports are submitted to LSCft Estates Management Assurance Meetings.
Communication
As part of the communications plan, LSCft’s Environmental Manager will represent LSCft at regional and national events, knowledge exchange meetings and/or conferences. In addition, a group of key LSCft members will be established as ‘Sustainable Green Champions’ from different areas of LSCft including Procurement, HR, Finance and IT. The group will meet three times per year and regular promotional events will be offered to the group.
Communications are also published within LSCft’s weekly newsletter as required to support the overall strategy. LSCft will develop and manage a dedicated webpage covering and communicating all key carbon and sustainable development areas.
Progress will be monitored and reported to the Board bi-annually regarding carbon reduction targets. An annual carbon submission is also made to the SDU.
Risk
In order for this GP to be effectively implemented and embedded within the Trust, any risks which may affect the ability to deliver the NZC targets and the sustainability agenda must be identified, logged and monitored through LSCft’s Risk Register. The risks should then be periodically reviewed at the relevant risk forum to ensure any blockers are actively managed by the Trust.
The following risks have been identified in association with delivery of this GP:
Risk 1: Finance
To deliver the commitments in this strategy, the Trust will be required to continue to support the infrastructure and technological improvements with appropriate funding.
Increasing energy prices and waste disposal costs may reduce some of the efficiency savings achieved.
Risk 2: Non-achievement of the carbon reduction targets
Due to the nature of the Trust’s services and geographical footprint, the clinical activity may intensify and estate growth may be unavoidable resulting in the carbon emissions increasing. Therefore LSCft will always measure and report on normalised information (e.g. per patient contact, bed day or per m2), working with the SDU to review and amend the baseline and target reductions.
Risk 3: Non-compliance with legislation
Due to the size, scale and complex nature of the organisation plus systems changes within the Integrated Care System (‘ICS’), there is a risk LSCft will not comply with legislation which could result in penalties and reputational damage. LSCft will mitigate this by working closely with the SDU to ensure all changes are reflected in the baseline and targets, plus ensure all risk systems, training and auditing of activities against the objectives in this plan provide sufficient assurance through Trust approved governance processes.
Risk 4: Reputation
LSCft’s reputation for sustainability is paramount to ensuring its performance. As one of the largest physical and mental health Trusts, it’s important that LSCft takes a leading approach and have a robust plan and reporting structure, including full Trust support in achieving all goals.
Finance
Effective management of the environmental and infrastructure performance provides significant financial benefits. Managing the Trust’s infrastructure efficiently and ensuring sustainable fixtures, fittings and equipment are the “first choice” option when refurbishing or maintaining the property portfolio are key to meeting the objectives within this GP.
Utilising ‘spend to save’ schemes funded by the Trust, Department of Health or external finance solutions will be required to ensure the Trust’s properties reduce overall operating costs and reduce their carbon impact.
LSCft will apply this approach to financing this GP:
- An annual budget will be requested within the capital allocation to deliver the plan and ensure compliance against all requirements, including medium internally financed investment to save schemes and sustainability programmes.
- Where there is a direct financial payback from our infrastructure schemes we will typically consider these to achieve a payback period of less than five years to ensure the investment is viable. However, we will not exclude longer term payback period schemes, particularly where there are wider benefits such as improving the quality of our care environments or improving the resilience.
- Where schemes are planned to be undertaken, such as new builds, lifecycle replacement and refurbishment of our estate, LSCft will provide options for the Trust to potentially increase funding to ensure that longer term energy or water savings are realised. An example of this would be replacement of the lighting scheme due to be completed with NHSi funding and extending the programme to properties not considered viable during the bidding process due to the payback period or changes in the estate portfolio.
- LSCft will actively pursue external financing for larger investments in energy and water reduction schemes. This may include Carbon Energy Fund (‘CEF’), Salix and NHS funding. We will review the options for joint ventures with partners and innovative opportunities, considering these on an ‘invest to save’ basis.
- LSCft will work with stakeholders to ensure the Trust can source local grant funding to invest in localised schemes across the Trust’s geographical footprint.